Lee
Stuart, FL

A heart murmur is a description of how the heart sounds when a veterinarian listens to it. The presence or absence of a heart murmur does not always correlate with the presence or absence of heart disease.

A heart murmur signifies turbulent flow of blood through the heart. Under normal circumstances blood flows through the heart smoothly and soundlessly. In animals with heart murmurs the blood does not flow as smoothly, and this causes a shushing noise that is called a heart murmur.

Blood flowing through the heart is similar to water flowing through a hose. A kink or irregularity in the hose can lead to a shushing noise as the water flows through. Any irregularity in the structure of the heart or the flow of blood through the heart causes a similar shushing noise.

Heart murmurs come in two broad categories: non-pathological and pathological. Non-pathological heart murmurs are caused by benign hereditary or developmental anomalies and other harmless irregularities in the structure (but not the function) of the heart.

Pathological heart murmurs are caused by leaky valves, irregularities in heart muscle structure, or anatomical irregularities that compromise heart function.

Animals like MidgeyGirl that develop heart murmurs at a young age often have non-pathological murmurs. Animals that develop heart murmurs late in life most often have pathological heart conditions.

However, there is absolutely no way to tell whether a murmur is pathological or non-pathological simply by listening to it. Diagnostic tests are needed to determine whether disease exists and whether medications are necessary.

A combination of chest X-rays and ultrasound of the heart (known as echocardiography) almost always reveals whether heart pathology is present. Basic blood tests (and a special blood test called pro-BNP) also are useful.

I recommend that your vet perform these tests on MidgeyGirl. Hopefully the results will put your mind at ease.

Go to my website for more information on heart disease in pets.
Cats: http://drbarchas.com/feline_heart_disease
Dogs: http://drbarchas.com/canine_heart_disease

Photo: Lola’s heart looks good!

Today I received the following action alert from the American Veterinary Medical Association (AVMA).

2009 H1N1 influenza virus confirmed in Iowa cat

November 4, 2009 – A 13-year old cat in Iowa developed signs of a respiratory infection after several people in the household were ill. Preliminary testing was positive for 2009 H1N1 on October 29, and the results were confirmed on November 2. This is the first report of a cat infected with H1N1. The cat has recovered from its illness.

To date, this is the first cat confirmed infected with the 2009 H1N1 virus. Two ferrets, one in Oregon and one in Nebraska, have also recently been confirmed infected with the 2009 H1N1 virus. The Nebraska ferret died, but the Oregon ferret has recovered. To date, there is no evidence that the ferrets or the cat passed the virus to people.

The American Veterinary Medical Association and American Association of Feline Practitioners are reminding pet owners that many viruses can pass between people and animals, so this was not an altogether unexpected event. We are advising pet owners to monitor their pets’ health very closely, no matter what type of animal, and visit a veterinarian if there are any signs of illness.

The good news, of course, is that the cat recovered and that animals have not yet been shown to pass the virus to humans.

I will continue to relay to my readers all of the information I receive on feline or canine H1N1 influenza.

People’s knowledge of history is poor. Very few of my clients are aware that merely six hundred and fifty years ago fleas spread a disease (bubonic plague, also known as black death) that wiped out a third of Europe and changed the nature of society forever. Only in the last 80 years has the plague receded as the preeminent threat to human existence.

Now that in the United States plague isn’t the imminent threat it once was, many people view fleas as merely pests.

Indeed, fleas are pests. But they are much more than pests. They are vectors for many diseases other than plague in cats and humans.

A page published recently on the NAVC Clinician’s Brief website discussed some of the vague, creepy diseases that fleas can spread to your cat–and to you.

I suggest you check it out. Also, don’t forget to read what I have written about the parasites on my website:

http://drbarchas.com/fleas

Image: The little fella almost looks cute. Don’t be fooled: he’s deadly!

Vetsulin insulin is widely used in diabetic dogs (and, occasionally, diabetic cats). I was therefore disturbed to receive the following e-mail from the American Veterinary Medical Association.

FDA-CVM Issues Alert About Problems with Vetsulin® Porcine Insulin Zinc Suspension

November 3, 2009 – The U.S. Food and Drug Administration’s Center for Veterinary Medicine, in cooperation with Intervet/Schering-Plough Animal Health, has announced that Vetsulin® may have varying amounts of crystalline zinc insulin, the active ingredient, in the formula. As a result, use of the product could result in a delay in action of the drug as well as prolonged action, which could cause difficulty in managing diabetic pets. Get more information on the AVMA web site, AVMA.org: http://www.avma.org/aa/vetsulin_091102.asp

If you administer Vetsulin to your pet, I recommend that you contact your veterinarian about this matter immediately. Unreliable insulin can lead to chronically high blood sugar in pets. Worse, it can lead to accidental insulin overdose. For information on the symptoms of insulin overdose in pets, go to my website:

http://drbarchas.com/insulin

A thorough general physical examination was unremarkable (unremarkable is how veterinarians say normal–we can’t actually say normal because the word normal, according to some malpractice insurance providers, implies things that can be very dangerous if we have missed something subtle).

The symptoms were consistent with an anal gland problem. If you never have heard of anal glands, consider yourself lucky. You may want to stop reading now in order to preserve your innocence.

The anal glands are bulbs located adjacent to the anus. The bulbs are connected to the anus by ducts. The glands produce a fluid with a unique odor. It smells like a combination of rotting fish, feces, and tear gas.

Cats and dogs have anal glands. Skunks do too–the glands are modified in skunks and are responsible for skunks’ unique smell.

The anal glands normally empty when a cat or dog defecates. In some instances, however, this does not happen as it should. The result is anal glands that are impacted and distended. Animals with impacted anal glands often drag their rear ends along the ground.

Impacted anal glands are treated by manual expression. The most effective means of manually expressing anal glands involves inserting a finger into the animal’s rectum and massaging the accumulated fluid out of the glands.

This is what I proposed for my patient whose hind end was so uncomfortable.

The owner accepted my proposal. However, she declined to accept my recommendation that the procedure be performed in a section of the hospital where only employees were present. She asked to be present while her dog’s anal glands were expressed.

Palpation of the glands revealed that they were both markedly distended. Both glands were expressed with ease. A large amount of fluid was released.

As the smell of the fluid filled the room, the owner of the Miniature Schnauzer soon was ill at ease. She complained of light headedness and dizziness. She asked to sit down. She retched and nearly vomited.

The nurse and I escorted her to some fresh air. She rapidly recovered. I blame myself for not warning her vehemently enough that anal gland fluid smells really bad.

After enough time one becomes inured to the smell of anal glands. To the uninitiated, however, it can be overpowering.

shannon
Middletown, Ohio

Overbites are very common in cats. Usually they are harmless. Cats are lucky to be less superficial than humans–cosmetic trivialities like overbites don’t lead to social ostracism or low self esteem.

Severe overbites can be more than a cosmetic problem. In some cases the teeth of the lower jaw can grow into the tissue of the upper jaw. This can lead to painful infections or areas of chronic inflammation (irritation).

The areas of chronic inflammation can look just like tumors. True tumors are extremely rare in the mouths of two-year-old cats.

I therefore wonder whether your cat actually has a tumor. It sounds more likely that a wayward tooth is causing chronic inflammation that looks like a tumor. I suspect that dental work (specifically, extraction of teeth that are growing improperly) might remove the source of inflammation and solve the problem permanently.

I agree that it is too soon to give up on your cat. Some local SPCAs have veterinary hospitals that offer discounted services to needy individuals. If such a facility is available in your area perhaps your cat can benefit from a procedure that will allow her to live a normal life.

Photo: no sign of an overbite on Ben.

People will leave Halloween candy unattended, in many cases just for a moment. Dogs will pounce upon and devour the candy, wrappers and all. I see the consequences of this every year, time and time again.

Fortunately, most Halloween candy contains milk chocolate (click the link to learn more about chocolate toxicity in dogs)–one of the least dangerous types. And many seasonal treats are made mostly of nougat, which isn’t technically toxic. The wrappers generally are harmless.

But any dog that eats enough Halloween candy is at risk of more than chocolate toxicity or an upset stomach. Each year I treat several dogs for pancreatitis after they devour a stash of sugary treats.

Pancreatitis is a life-threatening inflammation of an organ that is involved in the digestion of food. Dogs who recover from pancreatitis are at increased risk of diabetes later in life.

Have fun this Halloween. But watch the dog!

Paoline
Atlanta, GA

You don’t mention how old your dog is. If he is less than two years old, I am guessing that puppy mange is causing the bald spots.

Yes, I know, your dog twice tested negative for mange. But the test for puppy mange (which is caused by a mite called Demodex) occasionally yields false negatives. The test involves scraping the skin with a scalpel blade. This process harvests skin (and any parasites contained within the skin) from the affected area. The harvested sample is scanned under a microscope. If Demodex organisms are seen, the diagnosis is clear. If none are seen, then one of two things could be going on: either puppy mange isn’t causing the spots, or no Demodex organisms happened to be present in the area that was scraped.

Puppy mange most commonly causes patchy baldness without skin irritation (the spots generally aren’t red or itchy). The spots most commonly occur on the face. In my experience Pit Bulls are extremely susceptible to the syndrome.

If your dog’s spots aren’t bothering him and they aren’t coalescing to take over his face, I recommend that you try to wait it out. Almost every dog outgrows the problem by two years of age.

For more information on the syndrome, go to my website:

http://drbarchas.com/demodex

Photo: no sign of puppy mange on Tank.

Influenza viruses are known for infecting multiple species–as the name would imply, swine flu developed in pigs and then spread to people.

This may lead pet owners to wonder: can cats and dogs catch swine flu?

The answer appears to be no. DVM Newsmagazine reports that there is no evidence cats or dogs can contract, carry, spread, or suffer illness from H1N1 influenza.

H1N1 influenza has been isolated from a ferret. Fortunately at this time there is no evidence that ferrets can spread the disease to people.

Although it appears we can rest easy about our cats and dogs catching swine flu, remember that cats are susceptible to an even scarier form of influenza: bird flu (also known as H5N1). Cats contract bird flu by preying upon or being fed raw bird meat. The virus does not appear capable of spreading from cat to cat. That is a good thing, since the fatality rate among cats infected with H5N1 appears to be 100%.

Fortunately, it is easy to protect your cat from H5N1. If you feed your cat commercial or cooked food and keep him indoors, his chances of catching bird flu are nil.

Friday was Cody’s second birthday and on that night the family threw him a birthday party. Twenty-five people attended. Many of them were children. All of them brought gifts for Cody. Most of the gifts were edible.

During the party Cody received and immediately devoured several rawhides, pig’s ears, and sundry other dog treats. He also took the opportunity to hoover up any human food that was dropped during the party. His owner mentioned that one partygoer accidentally dropped an entire hamburger on the floor. Cody wolfed it down as the crowd sang Happy Birthday.

As the owner recounted this story I thought to myself that this massive amount of dietary indiscretion sounded like a good way for a dog to contract pancreatitis. Pancreatitis is a life-threatening inflammation of an organ (the pancreas) that is involved in the digestion of food. I began to get worried about Cody.

The owner’s story continued. The party ended uneventfully and everyone went to bed. The next morning (Saturday) Cody woke up feeling awful. He could barely move. He had no appetite (which, the owner assured me, was most extraordinary for Cody).

The owner was not very worried initially. But by Sunday afternoon Cody’s condition still had not improved. He refused to eat, and he still was extremely lethargic. He therefore wound up in my office.

When I examined Cody I was troubled. He was very lethargic. His abdomen was bloated and painful. He was extremely dehydrated. I recommended hospitalization and tests to rule out a serious problem such as pancreatitis or a foreign object (such as an undigested fragment of food) in his intestines.

Cody seemed to feel better after he was re-hydrated. And I was happy to see his test results. He tested negative for pancreatitis and other serious metabolic disturbances. His X-rays were not consistent with a foreign object in his intestinal tract.

However, the X-rays did show a very large amount of food in Cody’s stomach. This was most extraordinary in a dog who hadn’t eaten for two days. And it led to a diagnosis in the case–the best possible diagnosis considering the circumstances. Cody appeared to be suffering from a resolving case of glutton’s remorse (term coined by my friend Reading Maley).

Canine glutton’s remorse occurs when a dog overeats in the extreme. The stomach becomes massively and painfully distended, and the dog feels markedly ill for several days as the food slowly passes out of the stomach and through the intestines. The condition is painful and rarely triggers a life-threatening condition called bloat. However, most young dogs make it through episodes of glutton’s remorse unscathed. In my experience the condition is most common in Labs and Beagles (remember that Cody is a Lab/Beagle cross).

The nursing staff administered an enema to Cody in order to help keep everything moving through his system. I expect him to make a complete recovery. And I imagine that he never again will party as hard as he did on Friday night.

Photo: Feed me. Please. By Mzelle Laure.